J Rehabil Med 2019; 51: 734–740

REVIEW ARTICLE

KINESIO TAPING IN TREATMENT OF CHRONIC NON-SPECIFIC LOW BACK PAIN:

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A SYSTEMATIC REVIEW AND META-ANALYSIS

Yilan SHENG, MPT1,2, Zhouying DUAN, MD2,3#, Qiang QU, MPT2, Wenhua CHEN1,2 and Bo YU, MD, PhD1,2
From the 1Department of Rehabilitation, Shanghai General Hospital, Shanghai Jiaotong University, 2Department of Rehabilitation,
School of International Medical Technology, Shanghai Sanda University and 3Department of Rehabilitation, Shanghai Fifth Rehabilitation
Hospital, Shanghai, China
Journal of Rehabilitation Medicine

Objective: To compare the efficacy of kinesio taping

LAY ABSTRACT
on chronic non-specific low back pain with that of
Low back pain can be treated with a variety of ap-
other general physical therapies.
proaches, as described in clinical practice guidelines.
Methods: Relevant studies published up to 31 July
The aim of this study was to determine the efficacy of
2018 were searched in electronic databases (Pub-
kinesio taping for pain release and functional improve-
Med, Web of Science, Science Direct, Physiotherapy
ment in people with chronic low back pain. Significant
Evidence Database (PEDro), Cochrane Library, Wan-
pain relief was achieved in patients with low back pain
fang Data, Vip Data and China National Knowledge
with kinesio taping treatment, and taping was superior
Infrastructure). The quality of included studies was
to physical therapies, with improvement in functional
assessed using a risk of bias assessment tool, as
movement. Kinesio taping may be a new, simple and
recommended by the Cochrane Collaboration. Data
convenient choice for intervention in low back pain.
from visual analogue scales and Oswestry Disabi-
lity Index were extracted as selected outcome in-
dicators. Tests of heterogeneity were performed.
Chronic non-specific low back pain (CNSLBP) caused
Weight­ed mean difference (WMD) data with its 95%
by acute or chronic lumbar diseases can influence the
confidence intervals (95% CI) were used as a mea-
structure and functioning of the body, leading to reduced
sure of effect sizes, in order to pool the results from muscle strength, endurance capacity and mobility, and
each included study using either a fixed or random reduced ability in activities of daily living (ADL) (3).
Mechanical disorders, including injured intervertebral
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effects model (where appropriate and possible).

Results: Eight studies fulfilled the inclusion and ex-
clusion criteria. The quality of included studies was
moderate. Patients with chronic non-specific low
back pain in the kinesio taping group achieved bet-
ter pain relief (WMD = –1.22; 95% CI –1.49 to –0.96,
I2 = 91%, p < 0.00001) and activities of daily living
(WMD = –7.11; 95% CI –8.70 to –5.51, I2 = 77%,
Journal of Rehabilitation Medicine
disc, injury to a facet joint or sacroiliac joint, osteo-
arthritis and lumbar spinal stenosis, are responsible
for the main aetiology of CNSLBP (4, 5). In addition,
non-mechanical factors, such as infectious, neoplastic,
rheumatological, endocrinological, vascular, and gynae-
cological factors, are also associated with CNSLBP (5).
Self-report questionnaires, such as visual analogue

p < 0.0001) than those in the control group.
Conclusion: Kinesio taping may be a new, simple and
convenient choice for intervention in low back pain.
In the future, we can measure the efficacy about ki-
nesio taping via clinical application in order to prove
the possibility of treatment for low back pain.
Key words: kinesio taping; chronic non-specific low back
pain; visual analogue scale; Oswestry Disability Index.
Accepted Sep 4, 2019; Epub ahead of print Sep 23, 2019
J Rehabil Med 2019; 51: 734–740
Correspondence address: Bo Yu, Department of Rehabilitation, Shang-
hai General Hospital, Shanghai Jiaotong University, No. 100, Haining
Road, Shanghai 200080, China. E-mail: boyujtu@163.com
scales (VAS), and the Oswestry Disability Index (ODI),
are commonly used to identify the baseline status of
patients with chronic low back pain (6, 7). A VAS
questionnaire can be used to represent pain intensity
before and after treatment on a 0–10 scale, represen-
ting progressively increasing pain (6). The ODI is a
relative method to assess pain, flexibility, function,
and disability changes in a patient’s status. A higher
ODI score indicates more severe dysfunction (7).
These self-report questionnaires provide descriptions
of symptom grade, and are important for planning
clinical interventions or treatment.
Management of chronic low back pain currently
comprises a range of intervention strategies, including
physical treatments (e.g. electrotherapy, traction),

L ow back pain is a major health issue worldwide and

severely affects the quality of life of patients, resul-
ting in disability and work absence (1). A 2012 review
exercise therapy, manual therapy (mobilization/mani-
pulation and massage), drug therapy (e.g. paracetamol,
non-steroidal anti-inflammatory drugs (NSAIDs),
of the worldwide prevalence of low back pain reported opioids, muscle relaxants) and invasive procedures (e.g.
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a mean point prevalence of 11.9% (standard deviation acupuncture, injections and nerve blocks) (8, 9). In most
(SD 2.0) and 1-year prevalence of 23.2% (SD 2.9) (2). situations, the therapeutic effect of a single therapy is

This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm

doi: 10.2340/16501977-2605 Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977
 Effect of kinesio taping in chronic non-specific low back pain
not significant and a combination of the above methods
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is recommended to achieve a good curative effect.
Kinesio taping (KT) is the application of an elastic
tape, which can be stretched up to 140% of its original
length (approximately the stretch capability of normal
skin), for treating musculature-related conditions (10).
Journal of Rehabilitation Medicine
KT attached to injured skin or muscle regions may
enhance muscle strength, relieve spasms, pain and
oedema, improve blood circulation and lymph reflux,
as well as stabilize joints and increase range of mo-
tion (10–12). KT, as a rehabilitative taping technique
designed to promote the body’s natural healing process,
is widely applied in treatment of CNSLBP (13).
Although the application of KT for patients with
CNSLBP is increasing, overall comparison with other
therapies of its effectiveness has been little reported.
The aim of the current study was to systematically
compare the effect of KT or KT plus conventional
therapies (e.g. acupuncture, electric therapy or other
physical therapy) applied to patients with CNSLBP
with that of placebo taping or conventional therapies
through assessment of VAS and ODI data.
METHODS
This meta-analysis was performed in accordance with the
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Preferred Reporting Items for Systematic Reviews and Meta-
Analyses guidelines (PRISMA) (14).
Search strategy
Randomized controlled trials (RCTs) assessing the effect of KT
on patients with CNSLBP, published in Chinese or English, up
to 31 July 2018, were systematically retrieved from several
Journal of Rehabilitation Medicine
databases: PubMed, Web of Science, Science Direct, Physioth-
erapy Evidence Database (PEDro), Cochrane Library, Wanfang
Data, Vip Data and China National Knowledge Infrastructure.
Search terms were a combination of key words and free-text
terms (“chronic non-specific low back pain” OR “non-specific
low back pain” OR “low back pain” OR “back pain”) AND
(“kinesio taping” OR “elastic taping” OR “taping”).
Inclusion and exclusion criteria
Inclusion criteria for the studies were: (i) the design of the study
was an RCT and participants were patients with CNSLBP;
(ii) patients with CNSLBP should present with an episode of
chronic pain with limitation of motion in the lower back and
demonstrate a normal low back on X-ray, computed tomography
(CT) or magnetic resonance imaging (MRI); (iii) the study must
compare the effect of KT and other non-elastic taping or other
conventional therapy; (iv) the main outcomes of VAS and ODI
in individuals with CNSLBP were tested.
Exclusion criteria were: (i) the sample size was no more than
15 subjects (15) ; (ii) the full text was not available; (iii) relevant
outcomes were lacking; (iv) the study was a systematic review,
case report, comment or letter; (v) the study was published
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repeatedly; (vi) participants had clinical signs of spondylolis-
thesis, lumbar stenosis, infectious pathologies in the spine, or
735
inflammatory diseases with spine involvement; (vii) participants
had previously undergone spinal surgery.
Retrieved article titles and abstracts were read to assess
whether the study was eligible, with reference to the inclusion
and exclusion criteria above; otherwise, the full text was read
if the information was unclear.
Data extraction
Article selection and data extraction were completed inde-
pendently by 2 reviewers, and a consensus was achieved by
discussion. The following data were extracted from each
included study: name of first author, year of publication, study
characteristics (sample size, interventions, treatment frequency,
outcomes measure, and follow-up time), and participants’
characteristics (mean age, sex, and duration of disease). If the
original data was unclear or lacking, the corresponding author
was contacted to obtain further information. Articles were
excluded if the authors could not be contacted.
Quality assessment
The quality of each included study was assessed with a risk of
bias assessment tool, as recommended by the Cochrane Col-
laboration (16). This tool evaluates the selection, performance,
detection, attrition, and reporting bias with 7 items. If discre-
pancies were found for a specific item, a final agreement was
reached by discussion with a third reviewer. The Grading of
Recommendations Assessment, Development and Evaluation
(GRADE) system was applied to evaluate the overall quality of
the evidence and the strength of recommendations according to
outcome (17). The grade of confidence in the estimate of effect
was categorized into 4 levels: “very low”, “low”, “moderate”,
and “high”.
Quantitative data synthesis
Meta-analysis was performed with RevMan 5.3 software. VAS
and ODI were selected as outcome indicators. Weighted mean
difference (WMD) data with its 95% confidence intervals (95%
CI) was used as a measure of effect sizes to pool the results from
each included study. Heterogeneity within the included studies
was evaluated by Q test and I2 index (18). A fixed effects model
was applied for data synthesis when no significant heterogeneity
was detected (p > 0.05 or I2 < 50%) (19); otherwise, a random
effects model was used if significant heterogeneity was found
(p < 0.05 or I2 ≥ 50%) (20).
Sensitivity analysis
In order to investigate the heterogeneity of sources, sensitivity
analysis was conducted to assess the influence of each study on
the combined result by removing studies one at a time.
RESULTS
Eligible studies
A total of 203 articles were retrieved using the preli-
minary search strategy. Of these, 53 repeated articles
were excluded. After reading the abstracts, a further
95 irrelevant or ineligible articles were excluded. The
full texts of the remaining 55 articles were reviewed
J Rehabil Med 51, 2019
 736 Y. Sheng et al.

in detail, and 47 were removed based on the exclusion Quality assessment of the included studies
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and inclusion criteria. A final total of 8 eligible articles The quality of each included study is shown in Fig.
were therefore included in the present study (21–28) 2. The majority of studies had a low risk of bias in
(Fig. 1). random sequence generation, allocation concealment,
incomplete outcome data, and others. However, 5 stu-
Characteristics of included studies dies had a high risk of unblinding of participants and
Journal of Rehabilitation Medicine

The main characteristics of each included study are
shown in Table I. These studies were published during
2012–2015 and enrolled a total of 530 participants,
aged 18–80 years, including 257 male and 273 female
patients with CNSLBP. Patients with CNSLBP in the
control group were provided with conventional thera-
pies, including physical therapy (combined massage,
strength training and endurance training), combined
ultrasound, hot packs and transcutaneous electrical
nerve stimulation (TENS), separate acupuncture, or
separate high- + medium-frequency electric therapy,
etc., while patients in the treatment group were treated
with KT with or without the above interventions.
personnel, and 4 studies had a high risk of unblinding
of outcome assessment. In addition, all studies had a
high or unclear risk of selective reporting. Collectively,
the quality of included studies was moderate.
Data synthesis of outcome measures
VAS assessment. The VAS score was used as outcome
indictor in all the included studies. High heterogeneity
was detected within all included studies (p < 0.00001
and I2 = 91%), thus a random effect model was applied
to pool the VAS data of each study. The pooled results
demonstrated that significantly reduced pain was achie-
ved in 258 patients with CNSLBP with KT treatment

Table I. Summary of the basic information of included trials

Sample Sex VAS ODI
Study number Groups n (M/F) Age Course Taping Application Conclusion Conclusion
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Köroğlu et al., 60 KT+ combined 20 32/28 48.5±13.9 at least 3 2 I-shaped tapes; horizontally over the significant significant
2017 (21) ultrasound, hot packs and months dimples of the back; natural tension differences differences
electrotherapy
placebo taping + 20
combined ultrasound, hot
packs and electrotherapy
no taping+ combined 20
ultrasound, hot packs and
electrotherapy
Peng et al., 92 KT+high + medium 23 42/50 37.8±15.9 1 week - 2.5 I-shaped tape; the upper area of the back; significant significant
2015 (22) frequency electric therapy (22-65) years Y-shaped tape; along the lumbar muscle to differences differences
the L1 transverse protrusion; Y-shaped tape;
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high + medium frequency 23

treatment the 12th rib area; natural tension; both side
KT 23
conventional recumbent 23
position
Qiao et al., 30 KT +mobilization 6 days 18 0/30 65.33±4.84 3.98±0.72 2 I-shaped tapes; bending back; asterisk (*) significant significant
2017 (23) (60-75) months -shaped tape; the pain zone; natural tension differences differences
regular physical therapy 12
Su et al., 40 KT +regular physical 20 16/24 25-80 at least 1 asterisk (*) -shaped tape; the pain zone significant significant
2015 (24) therapy month differences differences
regular physical therapy 20
Song et al., 100 KT +acupuncture 50 44/56 39.99±8.46 5.33±2 “Y”-shaped tape; the first lumbar vertebrae significant significant
2016 (25) (29-65) months along the lumbar muscles; I-shaped tape; the differences differences
acupuncture 50 12th rib position; natural tension; both side
Suxia and 72 KT +regular physical 36 49/23 44.73±5.72 at least 3 I-shaped tape; the first lumbar spines to the significant significant
Baoqua, 2015 therapy (18-60) months top of the atlas; I-shaped tape; 12 ribs along differences differences
(26) regular physical therapy 36 the lumbar muscle; natural tension; both
side; 2 I-shaped tapes; the 5th lumbar spines
process and the thoracic 12 spines process to
both sides of the iliac crest; natural tension
Castro- 60 KT 30 40/20 48.5 (18- at least 3 4 I-shaped tapes; over the point of maximum significant significant
Sánchez et 65) months pain in the lumbar area; 25% tension differences differences
al., 2012 (27) sham KT 30
Dangpei et 76 KT +regular physical 38 34/42 38.5±8.05 9±2.2 I-shaped tape; from the first lumbar spine significant significant
al., 2017 (28) therapy (18-64) months above the atlas; I-shaped tape; the shoulder differences differences
rib line 12 ribs along the waist muscles until
the humerus is placed; natural tension; both
regular physical therapy 38 side; 2 I-shaped tapes; from the 5th lumbar
spines process and the 12 spine until the iliac
crest; natural tension; both side
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M: male; F: female; KT: Kinesio Taping; VAS: Visual Analogue Scale; ODI: Oswestry Disability Index. Physical therapy is a combined method of massage, strength
training and endurance training.

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 Effect of kinesio taping in chronic non-specific low back pain 737
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Records identified Additional records

through database identified through
searching (n=192) other sources (n=11)

Duplicate citations
removed (n=53)
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Records screened Records excluded

(n=150) (n=95)

Full text articles excluded

Full text articles
assessed for
eligibility (n=55)
(n=47):
Publication type (n=12)
Condition (n=13)
Intervention (n=12)
Outcomes/Comparison (n=10)

8 articles included
in analysis

Fig. 1. Flowchart of study selection for the meta-analysis.

compared with 252 patients in other conventional

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therapy groups (WMD = –1.22; 95% CI = –1.49 to
–0.96; Fig. 3). In addition, sensitivity analysis sho-
wed that a significantly reduced VAS was found after
omitting all included studies one at a time (ranges of
WMD (95% CI): –1.30 (–1.58, –1.02) to –1.10 (–1.33,
–0.86), p < 0.001), demonstrating that the pooled VAS
result was stable (Fig. 4).
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Fig. 2. Risk of bias assessment for the included studies. –: high risk of
bias; +: low risk of bias; ?: unclear risk of bias.
therapy. A stable ODI result was found by sensitivity
analysis after omitting the included studies one at a
time (ranges of WMD (95% CI) –7.51 (–9.17, –5.86)
to –6.20 (–7.37, –5.03), p < 0.001) (Fig. 6).

ODI assessment. All the studies reported the ODI

score, and significant heterogeneity was found among
these studies (p < 0.0001 and I2 = 77%). Therefore, the
random effect model was used for merging ODI score.
The WMD for ODI was –7.11 (95% CI –8.70 to –5.51,
Fig. 5), indicating that KT had a more positive effect
on improving ADL than other methods of conventional
GRADE evidence
The overall confidence in the estimates of VAS and
ODI was low due to the risk of bias and inconsistency,
which may reduce the recommendation strength of the
pooled results (Table II).

Fig. 3. Forest plot of efficacy evaluation according to visual analogue scale (VAS) (kinesio tape vs other therapy groups). Squares indicate outcome
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estimates for corresponding study, and the size of the square indicates the weight of the corresponding study. Horizontal lines and figures in parentheses
represent the 95% confidence interval (95% CI). Diamonds indicate the pooled effect size with the corresponding 95% CI. SD: standard deviation.

J Rehabil Med 51, 2019

 738 Y. Sheng et al.
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Journal of Rehabilitation Medicine

Fig. 4. Forest plot of efficacy evaluation on the Oswestry Disability Index (ODI) (kinesio tape vs other physical therapy groups).

DISCUSSION acupuncture and other general physical therapy met-

hods, for CNSLBP patient treatment, with reduced
This meta-analysis included 8 eligible studies that were
VAS and ODI. Similarly, Kelle et al. demonstrated a
relevant to the evaluation of efficacy of KT on pain
significant improvement in pain control in a KT group
relief and ADL progress for patients with CNSLBP.
compared with a control group for patients with acute
KT was found to be superior to other conventional
non-specific low back pain (29). A RCT study con-
therapies (e.g. physical therapy (combined massage,
ducted by Forozeshfard et al. demonstrated that KT
strength training and endurance training), acupuncture,
significantly reduces pain and functional disability
or high- + medium-frequency electric therapy) applied
in young females with menstrual low back pain (30).
to CNSLBP, with significantly decreased VAS and
Moreover, it has been reported that application of KT
ODI scores.
results in a significant reduction in neck and low back
The findings of the current study indicate that KT
pain, as well as disability indexes in surgeons with
is superior to other methods, including no taping,
musculoskeletal pain (31).
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Journal of Rehabilitation Medicine

Fig. 5. Results of sensitivity analysis for visual analogue scale (VAS) Fig. 6. Results of sensitivity analysis for the Oswestry Disability Index
after omitting each study one at a time. CI: confidence interval. (ODI) after omitting each study one at a time. CI: confidence interval.

Table II. Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence quality for each outcome
Quality assessment Number of patients
Other
Number Risk of considera­ Effect
of studies Design bias Inconsistency Indirectness Imprecision tions Experimental Control MD (95% CI) Quality Importance
VAS (follow-up median 4 weeks; less bias, better evidence] indicated by lower values)
8 RCT Serious Serious No serious No serious None 258 278 1.22 lower (1.49 to Low Important
indirectness imprecision 0.96 lower)
ODI (follow-up median 4 weeks; less bias, better evidence indicated by lower values)
8 RCT Serious Serious No serious No serious None 258 278 7.11 lower (8.7 to Low Important
indirectness imprecision 5.51 lower)
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95% CI: 95% confidence interval; ODI: Oswestry Disability Index; VAS: visual analogue scale; MD: mean difference; RCT: Randomized trials.

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 Effect of kinesio taping in chronic non-specific low back pain
Although a variety of studies demonstrate the effect
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of KT on pain relief, functional performance, disability
and improvement in ADL, the specific mechanism of
action of KT remains unclear. Possible explanations
for the mechanism of pain relief are that KT can ef-
fectively increase the kinesio taping may provide force
Journal of Rehabilitation Medicine
on skin and increase the gap which is underneath the
skin or the gap between epidermis and dermis, pro-
mote subcutaneous blood and lymphatic reflux, and
accelerate the healing of injured areas through its own
natural tension. In addition, KT can produce conti-
nuous sensory input to the skin sensors, which may
relatively suppress the sensory input of pain perception
(32). An additional possible explanation for functional
performance, disability or improvements in ADL is that
application of KT may increase the range of motion
of the temporomandibular joint during exercise (33).
Study limitations
Although this study resulted in some meaningful
implications, it also has several limitations. First, a
limited number of studies were included; there is a need
for more high-quality RCT studies with large sample
sizes to confirm the reliability of the present study.
Secondly, the total quality of included studies was rated
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as moderate, and overall confidence in the VAS and
ODI estimates was low, which may lead to overesti-
mation of effect and reduction in the recommendation
rate of our pooled results. Thirdly, because there are
few RCTs on this topic, this supports the inclusion of
other measures of pain and disability, and since we
only investigated VAS and ODI measures to assess
Journal of Rehabilitation Medicine
the pain and disability, it is possible that relevant stu-
dies may have been missed. Fourthly, methodological
heterogeneity occurred in many included studies, with
comparisons between different intervention strategies,
and several studies assessed the combined effect of KT
and other intervention strategies. Thus, further studies
are needed to compare KT separately with some speci-
fic general interventions. Finally, the shape, direction
and tensile force of KT for pain reduction or functional
performance are different in different individuals (34).
Further studies, focusing on the effect on pain reduc-
tion or improvement in functional performance using
different shapes, directions or tensile forces of KT,
should be included in the analysis.
Conclusion
This meta-analysis demonstrated that KT, either sepa-
rately or in combination with other general therapies,
resulted in greater pain relief and improvement in ADL
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in patients with CNSLBP than did general physical
therapies without KT.
739
ACKNOWLEDGEMENTS
This study was supported by the programme of Shanghai
Science and Technology Committee (No.16411955200) and
Scientific Research and Innovation Team Funding Plan of
Shanghai Sanda University.
The authors have no conflicts of interest to declare.
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